Condition assessment of water infrastructures: application to Segura river basin (Spain)

The paper deals with the condition assessment of water management infrastructures such as storage facilities, water mains and water distribution facilities. The objective is to develop a methodology able to provide a fast, simple assessment of present asset condition, that can also be used for predicting future conditions under different investment scenarios. The authors investigate the use of different methodologies to assess condition with focus on simple, indirect condition indices based on maintenance records, such as Infrastructure Value Index (IVI) and Asset Sustainability Index (ASI). The novelty of the approach presented is the development of a methodology that combines an asset inventory together with maintenance data, that can be integrated hierarchically, delivering an assessment of condition of elements, assets and groups of assets in a bottom-up fashion. The methodology has been applied to a group of water management infrastructures of the Segura River Basin in Spain. The main conclusion is that the proposed methodology allows to assess assets' sustainability based upon past and current trends in operation and maintenance budgets, providing a baseline for planning future maintenance actions.This research received no external funding

Reference measurements for WMO/CIMO SPICE and on-going projects at the Formigal-Sarrios field site

Comunicación presentada en: TECO-2016 (Technical Conference on Meteorological and Environmental Instruments and Methods of Observation) celebrada en Madrid, del 27 al 30 de septiembre de 2016.A WMO-SPICE (Solid Precipitation Intercomparison Experiment) site has been set up by AEMET (Spanish State Meteorological Agency) at Formigal-Sarrios in the Pyrenees range in 2013. The field site is located at 1800 m asl in a flat area in a subalpine environment with no vegetation, except for small amounts of grass. A DFIR (Double Fence Intercomparison Reference) was installed in 2014. Thanks to this infrastructure, unique in Spain and in the Pyrenees range, AEMET can participate in international solid precipitation intercomparisons. This experimental site represents the efforts of AEMET to contribute to improve the accuracy of the measurement of solid precipitation and to analyze the performance of observation devices in extreme conditions such as mountainous environments. The site will be also used as a long-term reference to monitor the changes in precipitation and to test and to compare new instruments in close collaboration with national and international partners. The site is at present equipped with numerous automatic devices measuring snow depth, snow water equivalent, total precipitation, air temperature, wind, air pressure, visibility, type of precipitation and radiation. This work gives an overview of the on-going projects and some preliminary results of interest for WMO-SPICE as well as for national interests such as hydrology, climatology and nowcasting

Famílies botàniques de plantes medicinals

Facultat de Farmàcia, Universitat de Barcelona. Ensenyament: Grau de Farmàcia, Assignatura: Botànica Farmacèutica, Curs: 2013-2014, Coordinadors: Joan Simon, Cèsar Blanché i Maria Bosch.Els materials que aquí es presenten són els recull de 175 treballs d’una família botànica d’interès medicinal realitzats de manera individual. Els treballs han estat realitzat per la totalitat dels estudiants dels grups M-2 i M-3 de l’assignatura Botànica Farmacèutica durant els mesos d’abril i maig del curs 2013-14. Tots els treballs s’han dut a terme a través de la plataforma de GoogleDocs i han estat tutoritzats pel professor de l’assignatura i revisats i finalment co-avaluats entre els propis estudiants. L’objectiu principal de l’activitat ha estat fomentar l’aprenentatge autònom i col·laboratiu en Botànica farmacèutica

Seguimiento de las guías españolas para el manejo del asma por el médico de atención primaria: un estudio observacional ambispectivo

Objetivo Evaluar el grado de seguimiento de las recomendaciones de las versiones de la Guía española para el manejo del asma (GEMA 2009 y 2015) y su repercusión en el control de la enfermedad. Material y métodos Estudio observacional y ambispectivo realizado entre septiembre del 2015 y abril del 2016, en el que participaron 314 médicos de atención primaria y 2.864 pacientes. Resultados Utilizando datos retrospectivos, 81 de los 314 médicos (25, 8% [IC del 95%, 21, 3 a 30, 9]) comunicaron seguir las recomendaciones de la GEMA 2009. Al inicio del estudio, 88 de los 314 médicos (28, 0% [IC del 95%, 23, 4 a 33, 2]) seguían las recomendaciones de la GEMA 2015. El tener un asma mal controlada (OR 0, 19, IC del 95%, 0, 13 a 0, 28) y presentar un asma persistente grave al inicio del estudio (OR 0, 20, IC del 95%, 0, 12 a 0, 34) se asociaron negativamente con tener un asma bien controlada al final del seguimiento. Por el contrario, el seguimiento de las recomendaciones de la GEMA 2015 se asoció de manera positiva con una mayor posibilidad de que el paciente tuviera un asma bien controlada al final del periodo de seguimiento (OR 1, 70, IC del 95%, 1, 40 a 2, 06). Conclusiones El escaso seguimiento de las guías clínicas para el manejo del asma constituye un problema común entre los médicos de atención primaria. Un seguimiento de estas guías se asocia con un control mejor del asma. Existe la necesidad de actuaciones que puedan mejorar el seguimiento por parte de los médicos de atención primaria de las guías para el manejo del asma. Objective: To assess the degree of compliance with the recommendations of the 2009 and 2015 versions of the Spanish guidelines for managing asthma (Guía Española para el Manejo del Asma [GEMA]) and the effect of this compliance on controlling the disease. Material and methods: We conducted an observational ambispective study between September 2015 and April 2016 in which 314 primary care physicians and 2864 patients participated. Results: Using retrospective data, we found that 81 of the 314 physicians (25.8%; 95% CI 21.3–30.9) stated that they complied with the GEMA2009 recommendations. At the start of the study, 88 of the 314 physicians (28.0%; 95% CI 23.4–33.2) complied with the GEMA2015 recommendations. Poorly controlled asthma (OR, 0.19; 95% CI 0.13–0.28) and persistent severe asthma at the start of the study (OR, 0.20; 95% CI 0.12–0.34) were negatively associated with having well-controlled asthma by the end of the follow-up. In contrast, compliance with the GEMA2015 recommendations was positively associated with a greater likelihood that the patient would have well-controlled asthma by the end of the follow-up (OR, 1.70; 95% CI 1.40–2.06). Conclusions: Low compliance with the clinical guidelines for managing asthma is a common problem among primary care physicians. Compliance with these guidelines is associated with better asthma control. Actions need to be taken to improve primary care physician compliance with the asthma management guidelines

Asset management in water infrastructure management: proposal of methodologies for a raw water management organization.

La gestión de activos como disciplina es un hito relativamente reciente. Desde sus orígenes hacia 1980 ha experimentado un notable desarrollo en diversos campos, desde la ingeniería a las finanzas. Su formalización se concretó en 2004 con la norma PAS 55 y con la publicación en 2014 de las normas ISO 55000 e ISO 55001. La gestión de activos en infraestructuras trata de armonizar de forma integral 3 objetivos básicos de toda organización: seguridad, niveles de servicio y viabilidad financiera. Los propietarios y gestores de servicios de suministro de agua en alta se enfrentan a una situación de crecientes demandas de servicio, deterioro de las infraestructuras, restricciones en la capacidad de inversión en mantenimiento, exigencia por parte de la sociedad de un desarrollo sostenible a largo plazo y a los desafíos derivados de la incertidumbre sobre la magnitud de los impactos del cambio climático. En el presente trabajo se expone los fundamentos de la gestión de activos y se analiza su aplicación a las infraestructuras hidráulicas de agua en alta, consideradas como activos, desde el triple punto de vista del servicio, la seguridad y el coste, con especial énfasis en la problemática tarifaria en los organismos de la administración hidráulica española. Se analizan y proponen indicadores de gestión que puedan emplearse en un Plan Estratégico de Gestión de Activos.Escuela de Ingeniería de Caminos y MinasUniversidad Politécnica de Cartagen

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function.Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system.Results: A total of 3288 patients were included in the analysis, of whom 301 (9.2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P < 0.001). There were no significant differences in rates of readmission between these groups (6.6 versus 8.0 per cent; P = 0.499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0.90, 95 per cent c.i. 0.55 to 1.46; P = 0.659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34.7 versus 39.5 per cent; major 3.3 versus 3.4 per cent; P = 0.110).Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients

Timing of nasogastric tube insertion and the risk of postoperative pneumonia: an international, prospective cohort study

Aim: Aspiration is a common cause of pneumonia in patients with postoperative ileus. Insertion of a nasogastric tube (NGT) is often performed, but this can be distressing. The aim of this study was to determine whether the timing of NGT insertion after surgery (before versus after vomiting) was associated with reduced rates of pneumonia in patients undergoing elective colorectal surgery. Method: This was a preplanned secondary analysis of a multicentre, prospective cohort study. Patients undergoing elective colorectal surgery between January 2018 and April 2018 were eligible. Those receiving a NGT were divided into three groups, based on the timing of the insertion: routine NGT (inserted at the time of surgery), prophylactic NGT (inserted after surgery but before vomiting) and reactive NGT (inserted after surgery and after vomiting). The primary outcome was the development of pneumonia within 30 days of surgery, which was compared between the prophylactic and reactive NGT groups using multivariable regression analysis. Results: A total of 4715 patients were included in the analysis and 1536 (32.6%) received a NGT. These were classified as routine in 926 (60.3%), reactive in 461 (30.0%) and prophylactic in 149 (9.7%). Two hundred patients (4.2%) developed pneumonia (no NGT 2.7%; routine NGT 5.2%; reactive NGT 10.6%; prophylactic NGT 11.4%). After adjustment for confounding factors, no significant difference in pneumonia rates was detected between the prophylactic and reactive NGT groups (odds ratio 1.03, 95% CI 0.56–1.87, P = 0.932). Conclusion: In patients who required the insertion of a NGT after surgery, prophylactic insertion was not associated with fewer cases of pneumonia within 30 days of surgery compared with reactive insertion